Northwestern Medicine cardiologist part of breakthrough study of
myocardial infarctions

Chicago, October 14, 2010- For nearly 40 years a class of drugs
known as beta blockers have been proven to increase patients’
survival prospects following a heart attack by decreasing the
cardiac workload and oxygen demand on the heart. In a breakthrough
study released in the American Heart Journal, Northwestern Medicine
cardiologist Jeffrey J. Goldberger found the majority of patients
are frequently not receiving a large enough dose of these drugs,
which can put their recovery from heart attacks and overall health
into peril.

“Only 46% of patients studied were taking 50% or more of
the target dose of beta blockers shown to be beneficial in clinical
trials,” said Goldberger, director of cardiac
electrophysiology research for the Bluhm Cardiovascular Institute
of Northwestern Memorial Hospital and a professor of medicine at
Northwestern University Feinberg School of Medicine.
“Furthermore, 76% of patients were still being treated with
the same amount of medication given at discharge. This means that
for the vast majority of patients, there wasn’t even an
attempt to increase their dose.”

Goldberger added that patients not getting the right amount of
beta blockers is a problem nationwide. “Beta blockers work to
keep patients alive after a heart attack, so proper dosing of beta
blockers can save many lives,” said Goldberger.

Northwestern Memorial was one of 19 sites that participated in
the PACEmaker and Beta-blocker Therapy Post-Myocardial Infarction
(PACEMI) Trial Registry. Nearly 2,000 patients, who had been
treated for a heart attack, were enrolled across the sites.

Study participants were prescribed very low doses at discharge,
in part to assess how their bodies were likely to react to the
drug. Researchers then followed up with patients three weeks later
to determine if their personal physicians had adjusted the dosage
amount.

“One of the reasons for the low dosage at discharge from
the hospital can be attributed to patients’ shorter length of
hospital stay,” said Goldberger. “Better communication
between patients and their personal physicians would help ensure
patients are receiving the appropriate dose of beta blockers more
quickly. Patients can be in and out of the hospital within two days
after a heart attack, and this short amount of time doesn’t
allow for us to increase their medication to the target dose while
they are still here.”

Goldberger added that there is not yet a system in place for
what should happen as an outpatient that used to happen as an
inpatient.

“Patients might see one doctor in the hospital but a
different one in the office, and those two might not be conferring
on the appropriate amount of beta blockers the patient should be
taking,” said Goldberger.

These findings make it clear, Goldberger added, that patients
and their personal physicians need to work together and have better
communication.

“Patients also need to schedule an initial doctor’s
appointment following their discharge within two weeks, so that
doctors can adjust the amount of medication in a timely
fashion,” said Goldberger. “I would expect 70-80% of
patients to achieve 50% or more of the target dose.”